Cooper Glinda S, Klebanoff Mark A, Promislow Joanne, Brock John W, Longnecker Matthew P
Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, North Carolina 27709, USA.
Epidemiology. 2005 Mar;16(2):191-200. doi: 10.1097/01.ede.0000152913.12393.86.
Experimental studies in nonhuman primates provide evidence that low-level exposure to persistent organochlorine pollutants such as polychlorinated biphenyls (PCBs) may affect aspects of their menstrual cycle, including cycle length, regularity, and bleeding duration. Few studies have examined these associations in humans.
We used data from 2314 pregnant women who participated in the Collaborative Perinatal Project, a cohort study that enrolled pregnant women in the 1960s in 12 centers in the United States. Information about usual (prepregnancy) menstrual cycle length, regularity, bleeding duration, and dysmenorrhea was collected at enrollment, and 11 PCBs and p,p'-DDE (1,1-dichloro-2,2-bis(p-chlorophenyl)ethylene (DDE) were measured in stored blood samples collected during the third trimester of pregnancy. We used multivariate linear and logistic regression to examine the association between organochlorine levels and menstrual cycles, adjusting for demographic factors, cholesterol, and triglycerides.
Total PCBs were positively associated with increasing menstrual cycle length (adjusted difference across 5 categories of PCB exposure = 0.7 days, trend-test P value = 0.02). Irregular cycles were slightly more frequent among those in the 2 highest categories of PCB exposure (odds ratio for highest category = 1.5; 95% confidence interval = 0.70-3.3), and there also was some evidence of an association with DDE. The strengths of these associations increased with various exclusions made to decrease potential misclassification of the outcome and the exposures. There was little evidence for associations between DDE or PCBs and bleeding duration, heavy bleeding, or dysmenorrhea.
This study supports experimental studies in monkeys showing an effect of low-dose PCB exposure on menstrual function.
对非人类灵长类动物的实验研究表明,低水平接触持久性有机氯污染物,如多氯联苯(PCBs),可能会影响其月经周期的多个方面,包括周期长度、规律性和出血持续时间。很少有研究在人类中探讨这些关联。
我们使用了来自2314名参与协作围产期项目的孕妇的数据,该队列研究于20世纪60年代在美国12个中心招募孕妇。在入组时收集了关于平时(孕前)月经周期长度、规律性、出血持续时间和痛经的信息,并在妊娠晚期采集的储存血样中测量了11种多氯联苯和p,p'-滴滴涕(1,1-二氯-2,2-双(对氯苯基)乙烯(DDE))。我们使用多变量线性和逻辑回归来检验有机氯水平与月经周期之间的关联,并对人口统计学因素、胆固醇和甘油三酯进行了调整。
总多氯联苯与月经周期长度增加呈正相关(多氯联苯暴露5个类别的调整差异=0.7天,趋势检验P值=0.02)。在多氯联苯暴露最高的两个类别中,月经周期不规律的情况略为常见(最高类别比值比=1.5;95%置信区间=0.70-3.3),并且也有一些证据表明与滴滴涕存在关联。随着为减少结果和暴露的潜在错误分类而进行的各种排除,这些关联的强度增加。几乎没有证据表明滴滴涕或多氯联苯与出血持续时间、大量出血或痛经之间存在关联。
本研究支持在猴子身上进行的实验研究,该研究表明低剂量多氯联苯暴露对月经功能有影响。